Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Institute for Health Promotion Research, UT Health San Antonio, San Antonio, Texas.
Cancer. 2018 Apr 15;124(8):1770-1779. doi: 10.1002/cncr.31263. Epub 2018 Feb 1.
The objective of the current study was to examine how modifiable factors such as satisfaction with cancer care and self-efficacy impact health-related quality of life (HRQOL) among Latino cancer survivors.
Latinos previously diagnosed with breast, prostate, or colorectal cancer (N = 288) completed questionnaires (Patient Satisfaction with Cancer Care Scale, Stanford Chronic Disease Self-Management Measures, Functional Assessment of Cancer Therapy-General, and Short Acculturation Scale for Hispanics) within 2 years after receiving primary cancer treatment.
Path model analyses demonstrated that satisfaction with cancer care was associated with greater HRQOL and that this relationship was explained by several facets of self-efficacy (ie, confidence in managing psychological distress [z = 3.81; P<.001], social support from close others [z = 2.46; P = .014], social/recreational activities [z = 3.30; P = .001], and patient-provider communication [z = -3.72; P<.001]). Importantly, foreign-born, less acculturated, and monolingual Spanish-speaking survivors reported lower self-efficacy in patient-provider communication; however, adjusting for acculturation, language, nativity, and other covariates did not alter these results.
Factors that contribute to disparities in HRQOL among Latino cancer survivors compared with non-Latino whites, such as low income, less education, and a lack of health insurance, can be difficult to address. The findings of the current study emphasize the importance of self-efficacy within the context of patient-centered cancer care practices (eg, patient inclusion in care decisions, sufficient time with provider, ready access to medical advice) and suggest that improving satisfaction with care may increase patients' confidence in managing important aspects of their cancer experience and, in turn, improve HRQOL among Latino cancer survivors. Cancer 2018. © 2018 American Cancer Society. Cancer 2018;124:1770-9. © 2018 American Cancer Society.
本研究旨在探讨可改变因素（如对癌症护理的满意度和自我效能感）如何影响拉丁裔癌症幸存者的健康相关生活质量（HRQOL）。
288 名先前被诊断患有乳腺癌、前列腺癌或结直肠癌的拉丁裔患者在接受主要癌症治疗后 2 年内完成了调查问卷（癌症护理满意度量表、斯坦福慢性病自我管理措施、癌症治疗功能评估-一般和西班牙裔人短文化适应量表）。
路径模型分析表明，对癌症护理的满意度与更高的 HRQOL 相关，而这种关系可以通过自我效能的几个方面来解释（即，对管理心理困扰的信心[z = 3.81；P<.001]、来自亲密他人的社会支持[z = 2.46；P =.014]、社交/娱乐活动[z = 3.30；P =.001]和医患沟通[z = -3.72；P<.001]）。重要的是，出生在国外、文化程度较低、只会说西班牙语的幸存者在医患沟通方面的自我效能感较低；然而，调整文化程度、语言、出生国和其他协变量后，这些结果并未改变。
导致拉丁裔癌症幸存者与非拉丁裔白人在 HRQOL 方面存在差异的因素，如低收入、受教育程度低、缺乏医疗保险，这些因素可能难以解决。本研究结果强调了自我效能感在以患者为中心的癌症护理实践中的重要性（例如，患者参与护理决策、与提供者有足够的时间、随时获得医疗建议），并表明提高对护理的满意度可能会增加患者对管理癌症经历重要方面的信心，从而提高拉丁裔癌症幸存者的 HRQOL。癌症 2018. © 2018 美国癌症协会。癌症 2018；124:1770-9. © 2018 美国癌症协会。
